Blues plans to launch high-performance network nationwide in 2021

Blues plans are launching a high-performance network nationwide. ( Jonathan Weiss/Shutterstock)

Blues plans are launching a high-performance network nationwide. 

The Blue Cross Blue Shield Association (BCBSA) revealed this week that its member plans would offer Blue HPN beginning in January 2021. The network will be available in 55 markets across the U.S. 

Jennifer Atkins, vice president of network solutions at BCBSA, told FierceHealthcare that the goal in launching the network was to build on the plans' existing value-based and patient-centered models. 

Webinar

Curating a Higher Level of Personalized Care: Digital Health + Mom

A long-term digital health strategy is needed to respond to the technology demands of the modern patient while thriving as an independent hospital in a fiercely competitive market. In this webinar, Overlake and one of its digital health partners, Wildflower Health, will discuss how Overlake has approached digital health and why it chose to focus early efforts on expectant moms within its patient population.

“As we pulled the plans together to work on this national profile, we found we have a lot of commonalities in our existing value-based arrangements,” Atkins said. 

There was strong interest in the individual markets for such a network, she said. About 70% of members in BCBSA plans are enrolled in a value-based contract. 

RELATED: New study aims to convince skeptical employers to embrace narrow networks 

Employers are taking a more “activist” role in healthcare, and part of that effort includes greater uptake of options such as direct contracting and high-performance networks to drive lower costs without pushing additional cost sharing for employees. 

Atkins said that existing value-based contracts deliver an average of 10% in total cost savings on top of savings in the Blue PPO, BlueCard, and that the BCBSA members expect a high-performance network to grow that number further. With 74 million members in its base, Atkins said the Blues plans believe they can reach the “critical mass” necessary to gather quality providers. 

In developing the networks, the plans will take a “best of local” approach that allows each plan to meet the needs of its markets under a shared set of standards. Quality metrics focus on offering the appropriate care, promoting adherence and boosting outcomes, and Blue HPN allows for individual plans to build in their own metrics to fit regional needs. 

“At the end of the day, we’re looking for providers who are really focusing on the overall health of the population and members, improving outcomes and being willing to take steps along this journey with us,” Atkins said. 

RELATED: Hospital Impact—The upside of narrow-network insurance plans 

The experience for members enrolled in Blue HPN is also highly local, Atkins said. The Blues insurers will work closely with employers to ensure that communication is clear and workers can understand what their plan entails. 

A key concern in a narrow-network plan is that members may not have a full grasp of what’s covered, which could put them at greater risk of unexpected medical bills that they cannot afford. 

"We have been working hard to ensure that when we’re communicating to employees through employers that choose the high-performance network they can be confident that they’re receiving the best care at the best price,” Atkins said. 

Suggested Articles

The nation’s highest court grappled with a key Affordable Care Act case Tuesday, with $12 billion in payments to insurers hanging in the balance. 

A nationwide effort to improve and coordinate patient safety measures will strive to make a connection between workplace and patient safety.

Cigna is in talks with New York Life Insurance Co. to sell off its group benefits insurance business in a deal that could be worth $6 billion.